This is the competitive renewal for the Medical Scientist Training Program (MSTP) at the Icahn School of Medicine at Mount Sinai (ISMMS). The MD/PhD program at Mount Sinai began in 1971 and in 1977 was awarded its first funding from NIGMS as an MSTP. For 39 years, our mission has been to educate future physician-scientists in a rigorous, integrated joint degree program. The program features an open and collaborative environment that fosters innovation in fundamental and translational biomedical research. Our trainees become independent investigators and leaders who apply basic science discoveries to improve healthcare in all communities. A large percentage of the trainees (82%) continue to pursue biomedical research (academic, pharma, federal agencies). During the past five years, ISMMS has continued to increase in ranking as one of the nation's top translational biomedical research institutions, 15th in research funding among US medical schools. Based on an ambitious Strategic Plan, ISMMS established a series of institutes that bridge basic science and clinical departments, strengthening our translational goals. A major centerpiece is a new translational research building, the Hess Center for Science and Medicine, that increased our research capacity by 30% and supported the recruitment of >200 new faculty, of whom 77 have joined the MSTP training faculty. In parallel, the numbers of highly qualified applicants to our MSTP have steadily increased. Our students achieve at a high level, as measured by publications, receipt of independent fellowship support, and matching in top residency programs. ISMMS has an outstanding record in the recruitment and retention of a diverse body of medical and graduate students. The MSTP has implemented a new program-specific integrated curriculum and also features courses that facilitate smooth transitions from preclinical to PhD and then from PhD to clinical training. Our MSTP also provides significant flexibility in the path through the program and opportunities for tailoring to the needs of the student. The Dean has invested considerable resources to build and strengthen the MD/PhD Program. In this application, we request funding to continue the MSTP beyond year 40. The MD/PhD Program at ISMMS provides an outstanding foundation for its students to develop successful careers as physician-scientists.